<div style="border-bottom: 2px blue solid; padding: 0 0 5mm 0; width: 190mm;">
<h1>{$title}</h1>
</div>
<table style="width:190mm; border: 0px black solid;" align="center" cellspacing="0" cellpadding="0">
	<tr>
		<td style="width: 18mm; text-align:right; ">
			<img src="logo_121x200.jpg" style="width: 16mm; height: 26mm;" />
		</td>
		<td style="padding: 8mm 0mm 5mm 5mm;width:75mm;" valign="top">
			<b>BGE PaRIF</b><br />
			6, avenue des Tuileries<br />
			91350 GRIGNY<br />
			<br />
			T&eacute;l.&nbsp;: 01 69 02 39 00<br />
			Fax&nbsp;: <br />
			<br />
			Dossier suivi par {$adviser.fullName}<br />
			Mail&nbsp;: {$adviser.email}
		</td>
		<td rowspan="2" style="padding: 8mm 0mm 5mm 5mm;width:75mm;" valign="top">
			<b class="fullname">{$owner.fullname}</b><br /> 
			{$owner.address}<br /> 
			<br /> 
			{if isset($owner.phone_number) gt 0 and trim($owner.phone_number) != ''}
			T&eacute;l.&nbsp;: {$owner.phone_number}<br /> 
			{/if}
			{if isset($owner.email) gt 0 and trim($owner.email) != ''}
			Mail&nbsp;: {$owner.email}<br /><br /> 
			{/if}
			{if isset($ownerData->NUMCAF->value) gt 0 and trim($ownerData->NUMCAF->value) != ''}
			N&deg; CAF&nbsp;: {$ownerData->NUMCAF->value}<br /> 
			{/if}
			{if isset($ownerData->NUMPEMPL->value) gt 0 and trim($ownerData->NUMPEMPL->value) != ''}
			N&deg; P&ocirc;le Emploi&nbsp;: {$ownerData->NUMPEMPL->value}<br /> 
			{/if}
			{if isset($ownerData->NUMTH->value) gt 0 and trim($ownerData->NUMTH->value) != ''}
			N&deg; TH&nbsp;: {$ownerData->NUMTH->value}<br />
			{/if}
			<br />
			Prescripteur&nbsp;: {$ownerData->service.label}<br />
			Contact&nbsp;: {$ownerData->referent}
		</td>
	</tr>
</table>
<br />
